Lifepoint Health® · 3 months ago
Reimbursement Specialist
Marquette, MI
Full-time
Onsite
Mid Level
3+ years expLifepoint Health® is dedicated to empowering a diverse workforce to drive quality care across its hospitals. The Reimbursement Specialist will reconcile payments, analyze discrepancies, and ensure timely posting of payments while collaborating with various departments to maintain compliance with billing procedures.
Health CareHospitalMedicalRehabilitation
Responsibilities
Maintains established hospital and departmental policies and procedures, objectives, performance improvement program, safety, environment of care, management of information, and infection control standards
Review and validate adjustments to accounts based on insurance reimbursement, coverage, contracts and services provided
Analyze and reconcile denied payment transactions
Audits payments from 3rd party payers for compliance with contracted amounts
Assists with the preparation and maintenance of department reports
Prepares periodic reports for senior management, as delegated by the director
Works closely with clinical staff, physicians, other department stakeholders, patient accounting and scheduling areas
Reviews charges for correct coding, completeness and accuracy of demographic and insurance data
Prepares specific financial reports as assigned
Reviews claim pertaining to billing, authorization, coding and documentation requirements. When necessary implements action plans to prevent denials and rejection recurrence with Directors approval
Coordinates various R1 processes to ensure expeditious billing performance
Demonstrates effective problem-solving, an ability to communicate verbally and in writing and a willingness to adapt to changing environment
Maintains working knowledge of the flow of information that supports the billing process, including medical documentation, CPT, HCPCS, ICD, MSDRG and other applicable documentation required for compliant billing
Assists in investigation, documentation and resolution of various input and output computer application problems as identified and reported by audit reports, computer vendors, Information Technology or support personnel as necessary
Promotes and maintains positive working relationships within the department and with other areas throughout UPHS-M, the community and outside agencies
Demonstrates professionalism with fellow employees, providers, and patients in person, on the telephone, and in writing
Demonstrates by his/her own behavior a strong sense of commitment to patient care
Demonstrates respect for individual dignity and diversity
Coordinates with other departments within the organization in a collaborative environment to ensure appropriate billing procedures are in compliance with third party payers, federal/state law and accrediting/licensing agencies
Maintains and fosters effective public relations with patients, staff, partners and the public
Qualification
Required
High school diploma
Current Coding Certification
3-5 years in medical billing
Knowledge of business functions
Familiar with collection procedures
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision
Must be able to work in a stressful environment and take appropriate action
Demonstrates effective problem-solving, an ability to communicate verbally and in writing and a willingness to adapt to changing environment
Maintains working knowledge of the flow of information that supports the billing process, including medical documentation, CPT, HCPCS, ICD, MSDRG and other applicable documentation required for compliant billing
Promotes and maintains positive working relationships within the department and with other areas throughout UPHS-M, the community and outside agencies
Demonstrates professionalism with fellow employees, providers, and patients in person, on the telephone, and in writing
Demonstrates by his/her own behavior a strong sense of commitment to patient care
Demonstrates respect for individual dignity and diversity
Coordinates with other departments within the organization in a collaborative environment to ensure appropriate billing procedures are in compliance with third party payers, federal/state law and accrediting/licensing agencies
Maintains and fosters effective public relations with patients, staff, partners and the public
Preferred
College degree in Business/Finance preferred
3-5 years supervisory experience preferred
Benefits
Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
Competitive Paid Time Off
Employee Assistance Program - mental, physical, and financial wellness assistance
Tuition Reimbursement/Assistance for qualified applicants
And much more...
Company
Lifepoint Health®
Lifepoint Health is a leading healthcare provider that serves patients, clinicians, communities and partner organizations across the healthcare continuum.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
$1.9B2024-05-09Debt Financing· $800M
2023-09-29Debt Financing· $1.1B
2018-07-23Acquired
Leadership Team
Jason Zachariah
Chief Operating Officer/EVP
Jennifer Peters
Executive Vice President Chief Administrative and Legal Officer
Recent News
HospitalManagement.net
2026-01-09
2026-01-07
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